Holman Alexis, Kruger Daniel J, Lucas Philippe, Ong Kaye, Bergmans Rachel S, Boehnke Kevin F
Chronic Pain and Fatigue Research Center, Anesthesiology Department, University of Michigan, Ann Arbor, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA.
Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, 426 Thompson St, Ann Arbor, MI, 48106, USA.
J Cannabis Res. 2022 Jun 13;4(1):32. doi: 10.1186/s42238-022-00141-0.
Patients use medical cannabis for a wide array of illnesses and symptoms, and many substitute cannabis for pharmaceuticals. This substitution often occurs without physician oversight, raising patient safety concerns. We aimed to characterize substitution and doctor-patient communication patterns in Canada, where there is a mature market and national regulatory system for medical cannabis.
We conducted an anonymous, cross-sectional online survey in May 2021 for seven days with adult Canadian federally-authorized medical cannabis patients (N = 2697) registered with two global cannabis companies to evaluate patient perceptions of Primary Care Provider (PCP) knowledge of medical cannabis and communication regarding medical cannabis with PCPs, including PCP authorization of licensure and substitution of cannabis for other medications.
Most participants (62.7%, n = 1390) obtained medical cannabis authorization from their PCP. Of those who spoke with their PCP about medical cannabis (82.2%, n = 2217), 38.6% (n = 857) reported that their PCP had "very good" or "excellent" knowledge of medical cannabis and, on average, were moderately confident in their PCP's ability to integrate medical cannabis into treatment. Participants generally reported higher ratings for secondary care providers, with 82.8% (n = 808) of participants rating their secondary care provider's knowledge about medical cannabis as "very good" or "excellent." Overall, 47.1% (n = 1269) of participants reported substituting cannabis for pharmaceuticals or other substances (e.g., alcohol, tobacco/nicotine). Of these, 31.3% (n = 397) reported a delay in informing their PCP of up to 6 months or more, and 34.8% (n = 441) reported that their PCP was still not aware of their substitution. Older, female participants had higher odds of disclosing cannabis substitution to their PCPs.
Most of the surveyed Canadian medical cannabis patients considered their PCPs knowledgeable about cannabis and were confident in their PCPs' ability to integrate cannabis into treatment plans. However, many surveyed patients substituted cannabis for other medications without consulting their PCPs. These results suggest a lack of integration between mainstream healthcare and medical cannabis that may be improved through physician education and clinical experience.
患者使用医用大麻治疗多种疾病和症状，许多人用大麻替代药品。这种替代往往在没有医生监督的情况下发生，引发了对患者安全的担忧。我们旨在描述加拿大医用大麻替代情况和医患沟通模式，该国拥有成熟的医用大麻市场和国家监管体系。
2021年5月，我们对在两家全球大麻公司注册的成年加拿大联邦授权医用大麻患者（N = 2697）进行了为期七天的匿名横断面在线调查，以评估患者对初级保健提供者（PCP）医用大麻知识的看法以及与PCP就医用大麻的沟通情况，包括PCP对许可证的授权以及大麻替代其他药物的情况。
大多数参与者（62.7%，n = 1390）从他们的PCP获得了医用大麻授权。在那些与PCP谈论过医用大麻的人中（82.2%，n = 2217），38.6%（n = 857）报告称他们的PCP对医用大麻有“非常好”或“优秀”的了解，并且平均而言，他们对PCP将医用大麻纳入治疗的能力有中等程度的信心。参与者对二级保健提供者的评价普遍较高，82.8%（n = 808）的参与者将他们的二级保健提供者对医用大麻的了解评为“非常好”或“优秀”。总体而言，47.1%（n = 1269）的参与者报告用大麻替代药品或其他物质（如酒精、烟草/尼古丁）。其中，31.3%（n = 397）报告在告知PCP方面延迟了长达6个月或更长时间，34.8%（n = 441）报告他们的PCP仍然不知道他们的替代情况。年龄较大的女性参与者向PCP披露大麻替代情况的几率更高。
大多数接受调查的加拿大医用大麻患者认为他们的PCP对大麻有了解，并对PCP将大麻纳入治疗计划的能力有信心。然而，许多接受调查的患者在未咨询PCP的情况下用大麻替代其他药物。这些结果表明主流医疗保健与医用大麻之间缺乏整合，这可能通过医生教育和临床经验得到改善。
